Healthcare Provider Details

I. General information

NPI: 1871419226
Provider Name (Legal Business Name): MICHAEL JAMES MARTIN STORMES NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12417 FAIR OAKS BLVD
FAIR OAKS CA
95628-2501
US

IV. Provider business mailing address

615 STONEYGATE CT
GALT CA
95632-3184
US

V. Phone/Fax

Practice location:
  • Phone: 916-727-1499
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number950394234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: